title: How to do it: importance of left atrial side retraction in robotic and minimally invasive mitral valve surgery.
abstract: A customized transthoracic atrial retractor was previously developed for robotic and minimally invasive mitral valve surgery, but it has sometimes failed to provide sufficient exposure of the mitral valve because some atrial tissues push away the operative field from the right side. This report describes 3 new atrial side retractors (the foldaway retractor, the spoon retractor, and the wired retractor) and their use in performing robotic mitral valve repair in fresh frozen human cadavers. These retractors provided exceptional and consistent exposure of the left atrium in robotic and minimally invasive mitral valve surgery in human cadavers without causing traumatic injury, and these retractors should be useful in live patients because they will be used in arrested hearts.
authors.affiliation: Center for Robotics and Minimally Invasive Surgery, The Brody School of Medicine at East Carolina University, Greenville, North Carolina 27858, USA. nori-i@mnx.jp
authors.forename: Norihiko
authors.initials: N
authors.lastname: Ishikawa
authors.forename: You Su
authors.initials: YS
authors.lastname: Sun
authors.forename: L Wiley
authors.initials: LW
authors.lastname: Nifong
authors.forename: Go
authors.initials: G
authors.lastname: Watanabe
authors.forename: W Randolph
authors.initials: WR
authors.lastname: Chitwood
mesh_terms: D013504:Cardiovascular Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006325:Heart Atria / Q000601:surgery*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D008943:Mitral Valve / Q000601:surgery*; D012371:Robotics / Q000295:instrumentation* / Q000379:methods; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods